Predictive significance of the European LeukemiaNet classification of genetic aberrations in patients with acute myeloid leukaemia undergoing allogeneic stem cell transplantation

• Published in: European journal of haematology Vol. 98; no. 2; pp. 160 - 168
• Main Authors: Hemmati, Philipp G., Vuong, Lam G., Terwey, Theis H., Jehn, Christian F., Coutre, Philipp, Penack, Olaf, Na, Il‐Kang, Dörken, Bernd, Arnold, Renate
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.02.2017
• Subjects: acute myeloid leukaemia; Acute myeloid leukemia; Adolescent; Adult; allogeneic stem cell transplantation; Combined Modality Therapy; European LeukemiaNet; Female; FLT3 internal tandem duplication; Genetic Variation; Health risk assessment; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Kaplan-Meier Estimate; karyotype; Leukemia; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Male; Middle Aged; Prognosis; Proportional Hazards Models; Recurrence; Retrospective Studies; Stem cell transplantation; Stem cells; Survival; Transplantation; Transplantation Conditioning; Transplantation, Homologous; Treatment Failure; Treatment Outcome; Young Adult; FLT3 internal tandem duplication; European LeukemiaNet; allogeneic stem cell transplantation; karyotype; acute myeloid leukaemia
• ISSN: 0902-4441; 1600-0609
• DOI: 10.1111/ejh.12815

Objectives The purpose of this study was to evaluate the predictive capacity of the European LeukemiaNet (ELN) classification of genetic risk in patients with acute myeloid leukaemia (AML) undergoing allogeneic stem cell transplantation (alloSCT). Methods We retrospectively analysed 274 patients transplanted at our centre between 2004 and 2014. Results The ELN grouping is comparable to the Southwest Oncology Group/Eastern Cooperative Oncology Group (SWOG/ECOG) stratification in predicting the outcome after alloSCT [overall P = 0.0064 for disease‐free survival (DFS), overall P = 0.003 for relapse]. Patients with an intermediate‐1 profile have a significantly elevated 5‐yr relapse incidence as compared to favourable risk patients, that is 40% vs. 15%, [hazard ratio (HR) 2.58, P = 0.048]. An intermediate‐1 risk profile is an independent predictor for relapse as determined by multivariate Cox regression analysis (HR 3.05, P = 0.023). In intermediate‐1 patients, the presence of an FLT3 internal tandem duplication (FLT3‐ITD) is associated with a significantly increased relapse incidence (P = 0.0323), and a lower DFS (P = 0.0465). FLT3‐ITD is an independent predictor for overall survival, DFS and relapse incidence in the intermediate‐1 subgroup. Conclusions The ELN stratification of genetic risk predicts the outcome of patients with AML undergoing alloSCT. Patients with an intermediate‐1 profile have a high risk for treatment failure due to relapse, which prompts the development of alternative treatment strategies.